Varicose veins

What is the difference between veins and arteries?

Varicose veins are permanently dilated (widened) and twisted
veins.

The heart pumps blood through the arteries to all parts of the
body – the vital organs, the head, arms and legs.

The blood is then spread through tiny vessels called capillaries
which form a network . Later it is returned in increasingly large vessels –
veins – which complete the circulation of blood back to the heart.

The arteries are rather thick and elastic and their size
constantly changes due to the fluctuating pressure which varies with the
heartbeat.

The veins, on the other hand, have very thin walls and have no
elastic fibres. They are therefore unable to contract and push the bloodflow
onwards.

The veins are completely dependent on the functions of the
surrounding muscles and the valves inside the veins helping the blood to flow
in the right direction towards the heart.

What are varicose veins?

Varicose veins are permanently dilated (widened) and twisted
veins. Although this can occur in any part of the body, it usually develops in
the legs.

Veins contain one-way valves every few inches to help the blood
return to the heart against gravity. If these valves leak, then the increased
pressure prevents the blood from draining properly.

The valves may leak and fail because of previous vein disease,
eg thrombophlebitis, pressure on the veins in the pelvis from pregnancy or
other causes of raised pressure within the abdomen.

Varicose veins come on with advancing age and are often no great
inconvenience apart from being unsightly.

How do I tell if I am developing varicose veins?

they appear as enlarged, snake-like, blue veins and are most
easily seen under the skin while standing

they are most commonly seen in the back of the calf or on the
inside of the leg between the ankle and the groin

there may be a creeping sensation across the skin and possibly
night-time cramps in the legs

the legs may become swollen, sore and painful as the condition
progresses. This is due to incomplete blood circulation (oedema or accumulation
of fluid in the legs).

When do I seek help?

Help should be sought when varicose veins cause irritation
during the day; if fluid accumulates in the legs; if working standing up causes
discomfort; or the legs become agitated at night (and sleep is interrupted).

In these cases consult a doctor about the possibility of
receiving treatment.

How are varicose veins treated?

Light to moderate physical activity, whilst avoiding factors
that are known to make your symptoms worse if possible.

When resting keep your legs elevated where possible.

In mild cases, lightweight elastic compression stockings
should ease the discomfort but they will not remove the varicose
veins.

There is no definitive system for identifying which people will
benefit the most from interventional treatment and no established framework
within the NHS for the diagnosis and management of varicose veins.

This has resulted in wide regional variations in the management
of varicose veins in the UK.

It is recommended for your GP to refer you to a specialist if
you have any of the following.

A venous leg ulcer (a break in the skin below the knee that has
not healed within 2 weeks).

A healed venous leg ulcer.

Interventional treatments of varicose veins in the leg can
involve a number of different types of intervention, listed below in the order
of preference, depending upon the severity and location of the veins.

Radiofrequency ablation of varicose veins. This involves
heating the wall of the vein using a bipolar generator and catheters with
sheathable electrodes.

Endovenous laser treatment of the long saphenous vein, which
runs up the inside of the leg from the ankle to the thigh.

Ultrasound guided foam sclerotherapy – the injection of a
sclerosing solution into the vein, which will close it.

If the veins are unsuitable for any of the above treatments, a
complete removal of the vein from ankle to groin may be necessary (ligation and
stripping).

For cosmetic improvement, small, localised 'spider veins'
(idiopathic telangiectases), which may be extensive, can be treated with
injections using a needle with a very fine bore.

Several treatments may be required before a satisfactory
resolution is achieved.

Laser treatment can also be effective for these small veins.

For most cosmetic cases however, this treatment tends to be
available privately rather than on the NHS. Your doctor will be able to advise
you as to the situation in your area.

Can varicose veins develop in places other than the
legs?

Varicose veins can develop, for example, in the oesophagus
(gullet or food pipe), pelvis, uterus (womb), vagina, scrotum and rectum (back
passage).
Haemorrhoids (piles)
can be regarded as varicose veins around the anus.

The majority of people with varicose veins manage by using
simple non-surgical treatment measures.

Varicose veins are not a disease in themselves although they can
cause daily irritation and worry. People with this problem should consult their
GP to discuss whether treatment is necessary.

The materials in this web site are in no way intended to replace the professional medical care, advice, diagnosis or treatment of a doctor. The web site does not have answers to all problems. Answers to specific problems may not apply to everyone. If you notice medical symptoms or feel ill, you should consult your doctor - for further information see our Terms and conditions.